28 June 2012

Supreme Court Upholds Health Care; Key Victory for LGBT, HIV+

In a huge election-year victory for President Barack Obama and fellow Democrats, the Supreme Court has upheld the landmark Affordable Care Act by a 5-4 decision. The much-anticipated decision is a "stinging setback for Republican opponents of the most sweeping overhaul of the unwieldy U.S. healthcare system in about a half century," notes Reuters.

In a 5-4 ruling based on the power of Congress to impose taxes, the court preserved the law's "individual mandate" requiring that most Americans obtain health insurance by 2014 or pay a tax.

Opponents of the law had argued the mandate was an overreach by the federal government into the private lives of citizens. The court was deeply divided on this issue, but the majority ruled that Congress' taxing power was more important. The law's "requirement that certain individuals pay a financial penalty for not obtaining health insurance may reasonably be characterized as a tax," Chief Justice John Roberts wrote for the court's majority.

"Because the Constitution permits such a tax, it is not our role to forbid it, or to pass upon its wisdom or fairness," wrote Roberts, who was joined by the four most liberal members - Justices Ruth Bader Ginsburg, Stephen Breyer, Elena Kagan and Sonia Sotomayor - in upholding the law's key provision.

The four dissenters, all from the court's conservative wing, were Justices Antonin Scalia, Anthony Kennedy, Clarence Thomas and Samuel Alito. They would have struck down the entire law.

The Supreme Court decision also upholds key provisions of the act that target the LGBT community, the transgender community and the nation's 1.2 million people who are HIV positive. Doctors and insurers will be prohibited from discriminating against and denying coverage to those who are HIV positive and/or transgender.

"This ruling is fair and humane, but it also reminds us of the work that remains to be done. People of color and economically impoverished people are disproportionately affected by health inequities. We have also long known that LGBT people - particularly LGBT people of color - suffer from higher rates of health disparities, and we continue to press for reform that addresses the stark realities that many of us face every day. This advocacy includes urging the Department of Health and Human Services to use its authority to make inroads in areas such as data collection and research on LGBT health disparities. We celebrate today, but also pledge to keep pressing forward."

This is a victory for all Americans,but in particular, the Court's decision today will save the lives of many people living with HIV - as long as states do the right thing. The Affordable Care Act will finally allow people living with HIV to access medical advancements made years ago but that have so far remained out of reach of many. With continuing prevention education, early detection, and quality care for everyone living with HIV, we have the power to stem the HIV/AIDS epidemic. But this is not a complete victory,because today's decision allows states to opt out of the Medicaid expansion that would provide insurance coverage for many low-income people who cannot otherwise afford it. Our continuing challenge will be to make sure that states opt to expand Medicaid so that more low-income people, and particularly those with HIV, can get the health care they urgently need.